Physicians are burned out: How healthcare finance leaders can help

• Significantly more physicians (58% compared with 40% two years ago) are suffering from burnout because of the COVID-19 pandemic, according to a survey conducted by the Physicians Foundation and reported in a Sept. 17 Modern Healthcare article.
• That is a 45% increase in physicians who are experiencing emotional exhaustion, depersonalization and reduced feelings of accomplishment, according to the article.
• Some 38% of physicians indicated they would like to retire in the next year, and 21% indicating this are 45 years old and younger, the article states.

A recent Modern Healthcare article highlighted a survey showing significantly more physicians are suffering from burnout because of the COVID-19 pandemic. The survey, conducted by the Physicians Foundation, found that 58% of physicians have feelings of burnout compared to 40%  in 2018. That is a 45% increase in physicians who are experiencing emotional exhaustion, depersonalization and reduced feelings of accomplishment.

Also, 38% of physicians indicated they would like to retire in the next year, according to the same article. A closer look shows it is not just older physicians wanting to retire; rather 21%  who indicated this are 45 years old and younger.

While hospitals and health systems have been focused on the costs of COVID-19 as it relates to resource use, disruption to care delivery and loss in elective procedures, the underlying costs as it relates to workforce burnout is significant and may play out over the months or even years to come. The result: Exacerbation of physician shortages and significant costs to health systems.

A research study published last year in the Annals of Internal Medicine found on a national scale, physician burnout resulted in $4.6 billion in costs related to physician turnover (i.e., revenue lost from referrals or procedures, interruption to care continuity and patients leaving the system) and reduced clinical hours.

At an organizational level, this comes to approximately $7,600 per employed physician each year. And this doesn’t take into account costs associated with medical errors, lower patient satisfaction or the impact a physician suffering from burnout can have on other staff or colleagues.  

As health systems recalibrate following the pandemic, it’s more important than ever to assess and address physician burnout. I reached out to physician health expert, Diane Shannon, MD, to get her perspective on the role of finance executives in addressing this issue. She shared these strategies:

• Develop a shadowing program: Executives and board members should shadow a physician for a day to understand the service challenges physicians face within their organization. The electronic health record, which is often a source for burnout, could benefit by having an IT specialist participate in shadowing a physician or others on the care team to help uncover opportunities for documentation and EHR optimization. Mission Health, based in North Carolina, has developed a robust immersion program that resulted in comprehensive changes that address inefficiencies and have had a positive impact on physician well-being.
• Review compensation and incentive structure: Organizations should consider how physician compensation is structured particularly in terms of productivity goals. Many compensation plans are based on RVUs over 52 weeks and fail to consider the pressure this creates in failing to incorporate vacation or personal time. Some organizations now set annual productivity goals based on 48 weeks rather than 52 weeks.   
• Invest in effective physician wellness programs: “Not yoga at lunch,” Shannon says, particularly when physicians don’t take lunch. Coaching has shown to be an effective intervention for physician well-being and decreasing stress and burnout.¹  One example Shannon cites comes from the leadership development at Novant Health that coaches physicians in a group setting on self-leadership, resilience, work-life balance and communication. Consider enhancing EAP benefits such as those offered through VITAL Work Life that offers a subscription  to physician well-being resources.
• Build a culture of wellness: A great first step is conducting annual physician wellness surveys. Shannon recommends Maslach Burnout Inventory or the Mini-Z burnout survey. Shannon says that when organizations implement an effective physician leadership program and a critical mass has completed the program, the culture of the entire organization can change. Fostering a more supportive culture can provide physicians with the bandwidth to engage in organizational strategies and address systemwide problems. Investments in physician wellness not only can be effective in and of itself, but it can also send a signal across the organization that physician well-being is a priority.

Finance executives are in a unique position of having a perspective of seeing the costs to the organization of recruitment and onboarding of new physicians compared with investments in physician wellness programs. Having the oversight of where to invest dollars that builds a strategy toward a culture of health and well-being is a powerful responsibility, and one finance and executive teams should appreciate. 

Footnote

¹ McGonagle, A. K., Schwab, L., Yahanda, N., Duskey, H., Gertz, N., Prior, L., Roy, M., and Kriegel, G. (2020), Coaching for primary care physician well-being: A randomized trial and follow-up analysis. Journal of Occupational Health Psychology. Advance online  publication and JAMA Internal Medicine 2019; 179(10):1406-1414. doi:10.1001/jamainternmed.2019.2425 Published online August 5, 2019.